Thursday, 28 June 2012

Little touches that make a BIG difference

One of the features of living with dementia is the constant
battle over what the mind can help the body to do. As the disease progresses
ability to do simple personal tasks, or even awareness that they need doing, can
gradually decline, making assistance with things that were previously taken for
granted much more important.

We all like to look and feel our best, and that certainly
doesn’t alter when someone has dementia, even if they cannot articulate it.
Their tolerance of having assistance may fluctuate however, as witnessed on the
many occasions I battled to file my dad’s nails whilst he valiantly tried to
prevent the emery board from doing its work.

Throughout every stage of my father’s dementia we strived to
keep him looking smart and feeling as comfortable as possible. He was always
a proud man, long before dementia ever came into his life, and it is almost as
if his pride was transferred to us when he could no longer maintain the
standards he had set himself.

Whilst it may sound quite simple, paying attention to the
little touches that make life more pleasant is surprisingly time consuming.
Apart from the shopping for clothes and bed-linen (dad had his own pure cotton
sheets, since all three of his care homes used the cheapest, nastiest
poly-cotton bed-linen that resulted in him sweating at night), I became an
expert in keeping him clean shaven (if the carers had not had time),
maintaining short nails (essential to limit his scratching) and regularly set
up in the hairdressing room to perform my duties as a barber.

When someone is living with dementia, their perceptions of
their appearance can alter quite dramatically. Mirrors are renowned to cause
problems, usually because what the person is seeing does not
reflect what they are thinking or expecting, and in my dad’s case when he
caught his reflection in a bathroom mirror shortly after I had cut his hair one
day, he exclaimed that he was, in fact, now bald! (He wasn’t).

Outside specialists came in to all three of dad’s care homes
to offer chiropody and eye tests, but when dad developed severe problems with
his teeth (long-standing issues existed anyway, but with his dementia keeping
them clean was a massive problem), we had to run the gauntlet of dental
services. Suffice to say that if doctors do not receive adequate training in
dementia, many dentists receive even less, and the few that we saw clearly
struggled to cope with a patient who could not understand instructions.
However, numerous appointments later and dad’s rotting teeth had all been
removed, which may sound very drastic, but poor dental health is known to cause
problems throughout the body and is a massive infection risk.

Introducing a full set of dentures to someone without the
ability to comprehend what on earth is being put into their mouth, and
therefore being completely unable to co-operate with this alien invasion,
proved very unsuccessful. Spending many years without a tooth in his head did
not bother dad one bit though. His gums toughened up, his oral health was greatly
improved, and his appetite remained one of the best, if not THE best, in the
whole of the nursing home.

For dad, another major problem was his skin. Keeping him
cool, particularly when he had no ability whatsoever to move himself, was a
constant round of opening and closing windows, using fans, adding and removing
layers of clothing, and hoping that the care home could finally get their
antiquated heating system to offer gentle, constant warmth rather than blasts
of hot and cold. Sweating meant itching, and with no ability to tell us when he
felt warm or cold, everyone needed to be very mindful of his body temperature.

Bloodied scratches became a regular feature on dad’s skin,
despite those short nails and us trying glove treatment, and indeed at one point
a GP even declared that dad had scabies (he didn’t, but the hassle this
diagnosis caused not just to the home but to us as his family in our homes –
which effectively had to be pulled apart and everything washed – is the stuff
of legend). Initially we trusted in the products prescribed by doctors to treat
dad’s skin, but when it got worse, it was plainly obvious that all the
chemicals and synthetic ingredients were making his skin, and his mood as a
result, ten-times worse.

Investment in natural skincare products made a huge
difference to dad’s life, and when the carers had the time to shower him
regularly and apply body creams and lotions, his skin was calm and moisturised
and his agitation disappeared immediately. To anyone else watching his
distress, you would have been tempted just to pop a pill into him to calm him
down, but a little thinking around the problem and a perfectly logical solution
was found.

Our experience was always that such small, yet common sense steps had an amazing effect on dad’s quality of life. He was always the smartest
resident in the home, but more than that, his personal care also brought him
calmness and comfort that he could not possibly ask for but that he really
needed. The things that many of us do regularly for ourselves can easily slip
when someone has dementia, but just like the ladies in the home having their
nails done or make-up applied, a little bit of pampering can become a fantastic
therapy, as well as giving people with dementia dignity and pleasure, and there
can be nothing more worthwhile than that.

1 comment:

I'm a weekend carer for a lovely lady with advanced vascular dementia. We put on her make up, do her nails, set her hair, she absolutely loves it. Her daughter said her previous carers didn't do this, and her mood has lifted considerably since we've been looking after her.

About Me

I'm a campaigner and consultant, writer and blogger. My dad had vascular dementia for approximately the last 19 years of his life. I aim to provide support and advice to those faced with similar situations, inform and educate care professionals and the wider population, promote debate and create improvements in dementia care.